Strengths

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Chapter: Pharmacovigilance: MEMO in the United Kingdom

One of the greatest advantages with using data from Tayside is the unique patient identifier.


STRENGTHS

PATIENT IDENTIFICATION

One of the greatest advantages with using data from Tayside is the unique patient identifier. This allows for relative ease of record-linkage and generation of comparator groups from the population. Selection of patients for both cohort and case–control studies is efficient.

POPULATION-BASED DATA

MEMO is regularly supplied with updated copies of the Community Health Master Patient Index from the Tayside Health Board, and uses this to track the population of patients alive and resident in Tayside to define study populations for drug safety studies. Such population-based data allow the calculation of incidence rates, excess risk and attributable risk.

DRUG EXPOSURE DATA

The data captured at MEMO represent prescriptions that have been dispensed at a pharmacy and so primary non-compliance is eliminated. In a study carried out to assess the extent of primary non-compliance in Tayside, a large family practice (11 500 patients) wrote all prescriptions in duplicate (carbon copy) form over a 3-month period (Beardon et al., 1993). The copies were sent to MEMO. The original top-copy forms that were redeemed by the patients at community pharmacies were also returned to MEMO by PPD. Duplicate forms for which no original was present represented the prescriptions that were not redeemed.

A further advantage of Tayside is that there is currently no structure to inhibit the prescribing of newly marketed drugs. Thus, studies of new agents that penetrate the market at a high rate are possible.

ACCESSIBILITY TO MEDICAL RECORDS

A major strength of MEMO is the ability to examine original hospital records where necessary. Several studies validating the computerised diagnos-tic data with the case records have been carried out, with variable results depending on the criteria used (Kohli and Knill-Jones, 1992; Park, McCabe and Russell, 1992; Pears et al., 1992). Within the National Health Service, such case record search-ing for the purposes of drug safety evaluation is ethically permissible once Medical Ethics Commit-tee approval from the Caldicott Guardians has been obtained (HMSO, 1992).

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